title: Factors affecting complication rates of percutaneous nephrolithotomy in children: results of a multi-institutional retrospective analysis by the Turkish pediatric urology society.
abstract: OBJECTIVE
  We assessed factors affecting complication rates of percutaneous nephrolithotomy in children.
  
  
  METHODS
  We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients 28.3% had a history of urolithiasis. Complications were evaluated according to the Satava classification system and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.
  
  
  RESULTS
  A total of 515 females and 642 males were studied. Mean ± SD patient age was 8.8 ± 4.7 years (range 4 months to 17 years). Mean ± SD stone size, operative time and postoperative hospital stay were 4.09 ± 4.06 cm(2), 93.5 ± 48.6 minutes and 5.1 ± 3.3 days, respectively. Postoperative stone-free rate was 81.6%. A total of 359 complications occurred in 334 renal units (27.7%). Complications were intraoperative in 118 cases and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, length of hospitalization, treatment success, punctured calyx and location of the stone significantly affected the complication rates (p <0.05), operative time, sheath size, mid calyceal puncture and partial staghorn formation were the statistically significant parameters affecting complication rates on multivariate logistic regression analysis.
  
  
  CONCLUSIONS
  Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates.
authors.affiliation: Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: bulonal@yahoo.com.
authors.forename: Bülent
authors.initials: B
authors.lastname: Onal
authors.affiliation: Department of Urology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Hasan Serkan
authors.initials: HS
authors.lastname: Dogan
authors.affiliation: Department of Urology, Cukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Satar
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Cenk Y
authors.initials: CY
authors.lastname: Bilen
authors.affiliation: Department of Urology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Güneş
authors.affiliation: Department of Urology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Ozden
authors.affiliation: Department of Urology, Selcuk University Faculty of Medicine, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.affiliation: Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Demirci
authors.affiliation: Department of Urology, Baskent University Faculty of Medicine, Ankara and Konya, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Istanbulluoğlu
authors.affiliation: Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Gurocak
authors.affiliation: Department of Urology, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Nazli
authors.affiliation: Department of Urology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Tanriverdi
authors.affiliation: Department of Urology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Kefi
authors.affiliation: Department of Urology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
authors.forename: Esat
authors.initials: E
authors.lastname: Korgali
authors.affiliation: Department of Urology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Mesrur Selcuk
authors.initials: MS
authors.lastname: Silay
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kubilay
authors.initials: K
authors.lastname: Inci
authors.affiliation: Department of Urology, Cukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Izol
authors.affiliation: Department of Urology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Altintas
authors.affiliation: Department of Urology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Kilicarslan
authors.affiliation: Department of Urology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Saban
authors.initials: S
authors.lastname: Sarikaya
authors.affiliation: Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Veli
authors.initials: V
authors.lastname: Yalcin
authors.affiliation: Department of Urology, Baskent University Faculty of Medicine, Ankara and Konya, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Aygun
authors.affiliation: Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Fetullah
authors.initials: F
authors.lastname: Gevher
authors.affiliation: Department of Urology, Cukurova University Faculty of Medicine, Adana, Turkey.
authors.forename: Ibrahim Atilla
authors.initials: IA
authors.lastname: Aridogan
authors.affiliation: Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Tekgul
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000378:metabolism*; D052878:Urolithiasis / Q000378:metabolism*
keywords: child; kidney calculi; nephrostomy; percutaneous